health insurance Online

Auto Insurance | Home, Condo & Tenant Insurance | Life Insurance | Universal Life | Health, Drugs & Dental | Critical Illness | Disability Insurance | Travel Insurance | Group | Long Term Care Insurance | Visitors To Canada | IPP | RRSP,RESP & RRIF | Guaranteed Withdrawal Plan | Annuities & Segregated Funds |Quick Investment Loan


Win A Chance For A Gift Certificate


Sign-Up and Learn How to Save Thousands on Insurance with Our Free Reports, Tips & Advice!


E-Mail:
daniel.latour@
 justincaseinsurance.com

MSN Messenger:(Live Chat)

latourdaniel@msn.com

Skype:
daniel.la.tour

Telephone:
1-514-630-6116

Toll Free Line:
1-888-977-7778

Toll-Free Fax:
1-888-637-2636

Mailing Address:
800 Rene-Levesque Ouest
P.O. Box 1408
Montreal, Quebec
CANADA H3B3L2

Regional Offices:
410-2001
McGill College Avenue
Montreal, Quebec
CANADA H3A1G1


200-1122 4 Street SW
Calgary, Alberta
CANADA T2R1M1

 
Guaranteed Issue Life Insurance to Protect Your Family
  • No Medical Exams
  • No Doctor's reports
  • No needles
more info...


You Can Earn Thousands With Our Fundraiser! Click Here for details.

 

Annuities & Segregated Funds
Investor Profile


Your Personal Data:
 
Your Name:
Street Address:
City:
Province:
Postal Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):

Sex (M/F): Smoker or
Non-Smoker?:

HOW MUCH MONEY DO YOU HAVE TO INVEST OR ARE SEEKING TO TRANSFER INTO A NEW INVESTMENT OPPORTUNITY?

Your Message:

FINANCIAL OBJECTIVES AND TIME HORIZON

1. Which of the following statements best describes your objective for the money you are investing?

a)   Preservation of Capital
b)   Growth through a balance of capital gains and income
c)   Growth through capital gains and some income
d)   Growth primarily through capital gains

 
2. How long do you plan to have that money invested?

a)  Under 2 Years
b)  2 - 5 Years
c)  6 - 10 Years
d)  11 - 15 Years
e)  Over 15 Years

3. What is the chance that you may wish to cash in a significant portion of this investment earlier than anticipated?

a)  Low (Less than 10%)
b)  Medium (Between 10% - 25%)
c)  High (Over 25%)

INVESTMENT EXPERIENCE AND KNOWLEDGE

4. Which of the following best describes your level of investment knowledge?

a)   Novice
b)   Some familiarity
c)   Reasonably knowledgeable
d)   Quite knowledgeable
e)   Very knowledgeable

 
ATTITUDE TOWARDS RISK

5. Typically, investments which are more volatile (i.e., tend to go up and down in value) will, over the long term, have greater potential for return. With regards to this statement, how much of a drop in value over one year could you tolerate before becoming uncomfortable?

a)   Less than 10%
b)   1% to 3%
c)   3% to 5%
d)   6% to 10%
e)   More than 10%

 
6. Investments that offer the highest potential of returns typically have the greatest variability of returns. Given this statement, assuming you had a $10,000 investment, please select one of the following gain/loss scenarios that you would be most comfortable with after a five-year investment time period. The gain/loss scenarios below show range of the potential value of the $10,000 investment at the end of the five-year period.

a)   Highest $13,500 Lowest $10,400
b)   Highest $17,100 Lowest $9,700
c)   Highest $19,700 Lowest $8,800
d)   Highest $21,800 Lowest $7,900
e)   Highest $26,600 Lowest $6,700

PERSONAL INFORMATION

7. Which of the following best describes your employment circumstances?

a)   Full-time
b)   Self-employed
c)   Part-time
d)   Retired
e)   Other

 
8. Your personal income, before taxes, is in which of the following ranges:

a)   Under $25,000
b)   $25,000 - $50,000
c)   $50,001 - $80,000
d)   $80,001 - $125,000
e)   Over $125,000

9. The current value of your investments (i.e., registered, non-registered, mutual funds, segregated funds, checking/savings accounts) excluding real estate is:

a)   $25,000 or less
b)   $25,001 - $50,000
c)   $50,001 - $100,000
d)   $100,001 - $250,000
e)   Over $250,000

10. Your current age is within which of the following categories:

a)   Under 30
b)   30 - 39
c)   40 - 54
d)   55 - 69
e)   Over 69

Send my results via:

E-Mail Fax
Regular Mail
Call Me by Phone


Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Get Us The Quote!


 


Français

Schedule An Appointment

Testimonials

10 Great reasons to Apply for Universal Life Insurance


About Us | Career Opportunities | Franchise Info. | Contact Us | Resources | Links | Videos | eNewsletters | English | Français | Legal / Compliance Disclosure Terms of Use / Privacy Notice
This page was last updated on : April 19, 2008
Please report site-related technical problems to: daniel.latour@justincaseinsurance.com
Copyright © 2008 JustinCase. Insurance-Web-Sales — all rights reserved.